<!DOCTYPE HTML>
<html  lang="zh" xmlns:th="http://www.thymeleaf.org">
<meta charset="utf-8">
<head th:include="include :: header"></head>

<body class="white-bg">
    <div class="wrapper wrapper-content animated fadeInRight ibox-content">
        <form class="form-horizontal m" id="form-personal-add">
        	<div class="form-group">	
				<label class="col-sm-3 control-label">主治医生：</label>
				<div class="col-sm-8">
					<input id="zhuzhiyisheng" name="zhuzhiyisheng" th:value="${zhuzhiyisheng}" disabled="disabled" class="form-control" type="text">
				</div>
			</div>
			<div class="form-group">	
				<label class="col-sm-3 control-label">病人姓名：</label>
				<div class="col-sm-8">
					<input id="patientName" name="patientName" class="form-control" type="text">
				</div>
			</div>

			<div class="col-md-12">
			    <div class="form-group">
			        <label class="col-sm-3 control-label">性别：</label>
			        <div class="col-sm-9">
			            <label class="radio-box">
			                
			                    <input type="radio" checked="" value="男" id="optionsRadios1" name="patientSex" style="position: absolute; opacity: 0;"><ins class="iCheck-helper" style="position: absolute; top: 0%; left: 0%; display: block; width: 100%; height: 100%; margin: 0px; padding: 0px; background: rgb(255, 255, 255); border: 0px; opacity: 0;"></ins>
			                男</label>
			            <label class="radio-box">
			               
			                    <input type="radio" value="女" id="optionsRadios2" name="patientSex" style="position: absolute; opacity: 0;"><ins class="iCheck-helper" style="position: absolute; top: 0%; left: 0%; display: block; width: 100%; height: 100%; margin: 0px; padding: 0px; background: rgb(255, 255, 255); border: 0px; opacity: 0;"></ins>
			                女</label>
			        </div>
			    </div>
			</div>

			
			<div class="form-group">	
				<label class="col-sm-3 control-label">年龄：</label>
				<div class="col-sm-8">
					<input id="patientAge" name="patientAge" class="form-control" type="text">
				</div>
			</div>
			<div class="form-group">	
				<label class="col-sm-3 control-label">手机号：</label>
				<div class="col-sm-8">
					<input id="patientPhone" name="patientPhone" class="form-control" type="text">
				</div>
			</div>
			<div class="form-group">	
				<label class="col-sm-3 control-label">身份证号：</label>
				<div class="col-sm-8">
					<input id="patientCard" name="patientCard" class="form-control" type="text">
				</div>
			</div>
			<div class="form-group">	
				<label class="col-sm-3 control-label">病人地址：</label>
				<div class="col-sm-8">
					<input id="patientAddress" name="patientAddress" class="form-control" type="text">
				</div>
			</div>
			
			<div class="form-group">
				<label class="col-sm-3 control-label">病种：</label>
				<div class="col-sm-8">
					<select id="icdCode" name="patientBingname" class="form-control"><!--  th:disabled="${post.status == '1'}" 条件判断-->
						<option th:each="post:${posts}" th:value="${post.id}" th:text="${post.idcName}"></option>
					</select>
					
				</div>
			</div>
			<div class="form-group">	
				<label class="col-sm-3 control-label">家属名称：</label>
				<div class="col-sm-8">
					<input id="patientJiashuname" name="patientJiashuname" class="form-control" type="text">
				</div>
			</div>
			<div class="form-group">	
				<label class="col-sm-3 control-label">家属手机号：</label>
				<div class="col-sm-8">
					<input id="patientJiashuphone" name="patientJiashuphone" class="form-control" type="text">
				</div>
			</div>
			<div class="form-group">	
				<label class="col-sm-3 control-label">与病人关系：</label>
				<div class="col-sm-8">
					<input id="patientGuanxi" name="patientGuanxi" class="form-control" type="text">
				</div>
			</div>
			<!-- <div class="form-group">
				<label class="col-sm-3 control-label">是否传染病：</label>
				<div class="col-sm-8">
					<select class="form-control" name="patientSfcrb">
						<option disabled selected>---请选择---</option>
				        <option value="是">是</option>
				        <option value="否">否</option>
				    </select>
				</div>
			</div> -->
			<div class="form-group">
				<label class="col-sm-3 control-label">是否传染病：</label>
				<div class="col-sm-8">
					<select class="form-control" name="patientSfcrb">
						<option disabled selected>---请选择---</option>
				        <option value="是">是</option>
				        <option value="否">否</option>
				    </select>
				</div>
			</div>
			<div class="form-group">
				<label class="col-sm-3 control-label">是否启动疾病预案：</label>
				<div class="col-sm-8">
					<select class="form-control" name="yuanYesOnNo">
						<option disabled selected>---请选择---</option>
				        <option value="是">是</option>
				        <option value="否">否</option>
				    </select>
				</div>
			</div>
			<div class="form-group">
				<label class="col-sm-3 control-label">疾病预案选择：</label>
				<div class="col-sm-8">
					<select class="form-control" name="yuanName">
						<option disabled selected>---请选择---</option>
				        <option value="传染病">传染病</option>
				        <option value="急诊">急诊</option>
				        <option value="手足口">手足口</option>
				        <option value="紧急病种">紧急病种</option>
				        <option value="空气传播类型">空气传播类型</option>
				        <option value="动物传播类型">动物传播类型</option>
				    </select>
				</div>
			</div>
		</form>
	</div>
    <div th:include="include::footer"></div>
    <script type="text/javascript">
		var prefix = ctx + "module/personal"
		$("#form-personal-add").validate({
			rules:{
				xxxx:{
					required:true,
				},
			}
		});
		
		function submitHandler() {
	        if ($.validate.form()) {
	            $.operate.save(prefix + "/add", $('#form-personal-add').serialize());
	        }
	    }
	</script>
</body>
</html>
